AAN guideline: plasma exchange effective in treating multiple sclerosis relapses, neuropathies

Jan 18, 2011

A new guideline from the American Academy of Neurology recommends using plasma exchange to treat people with severe relapses in multiple sclerosis (MS) and related diseases, as well as those with certain kinds of neuropathies. The guideline is published in the January 18, 2011, print issue of Neurology®.

The guideline recommends doctors consider using plasma exchange as a secondary treatment for severe flares in relapsing forms of multiple sclerosis and related diseases. The treatment was not found to be effective for secondary progressive and chronic progressive forms of multiple sclerosis. According to the guideline, doctors should offer plasma exchange for treatment of severe forms of Guillain-Barré syndrome and for temporary treatment of chronic inflammatory demyelinating polyneuropathy. Plasma exchange may also be considered for treatment of some other kinds of inflammatory neuropathies.

"These types of neurologic disorders occur when the body's immune system mistakenly causes damage to the nervous system. Plasma exchange helps because it removes factors in the plasma thought to play a role in these disorders," said guideline lead author Irene Cortese MD, a neurologist with the National Institutes of Health in Bethesda, Maryland, and a member of the American Academy of Neurology.

The guideline authors also looked at the use of plasma exchange for other neurologic disorders, including myasthenia gravis and pediatric autoimmune neuropsychiatric disorders (PANDAS), but there was not enough evidence to determine whether it is an effective treatment.

Side effects of plasma exchange include infection and blood-clotting issues.

The guideline was endorsed by the American Association of Neuromuscular and Electrodiagnostic Medicine. The National Multiple Sclerosis Society endorsed the section of the guideline that relates to the use of plasma exchange for multiple sclerosis.

Source: News Release
American Academy of Neurology
January 17, 2011